Grant Recipient Describes Project to Support Kenyan Children Affected by HIV

Last year, the Coalition for Children Affected by AIDS and ViiV Healthcare’s Positive Action awarded $40,000 in grants to eight organizations that could show how the use of social protection supports HIV testing, treatment, and care for children in low- or middle-income countries. Each winner received $5,000 to produce a scientific article, video, or written case study to show what works.

One of the winning proposals was submitted by the Catholic Diocese of Ngong to document its program to support orphans and vulnerable children (OVC) in Kenya. The work is being funded by Christian AID and Pathfinder International with the support of a USAID grant. The Coalition spoke to the project’s coordinator, Josiah Kiarie, who is overseeing operations in the counties of Kajiado and Narok.

Q: How did your project get started?

About 10 years ago, USAID invited community-based organisations to apply for funding to support orphans and vulnerable children in Kenya. The Catholic Diocese of Ngong was already subsidising food for vulnerable people and implementing nutrition and WASH (water, sanitation, and hygiene) projects supported by donors, so we decided to apply, and our Orphans and Vulnerable Children project was born. The first phase of the project ran from 2012 to 2017, and we are now in the second phase, which ends in 2022.

Q: Why did you choose Kajiado and Narok counties for your program?

Both areas have a high prevalence of HIV, low ART coverage, high levels of HIV-related stigma, and a growing population of children living with HIV. The counties have historically been semi-arid, but the weather patterns have been changing, leading to prolonged periods of drought. This has hurt local economies, which are dominated by livestock farming, and led to malnutrition and lack of food for families. Insufficient food is the main reason that HIV-positive children are not taking their medication, since it is uncomfortable to take meds on an empty stomach.

Lack of government accountability and transparency is a problem in Kajiado and Narok, as well. There is ineffective oversight, and public funds are often lost through pilfering. This has led to poor investment in public health and infrastructure. Some of the children we work with must travel 50 kilometers to reach the nearest clinic. Women also have limited opportunities to work and go to school, gender-based violence is rife, and many girls become pregnant at a young age. Female genital mutilation is also practiced in some communities. All of these factors make life more difficult for children affected by HIV and their families.

Q: Tell us about your project.

The goal of the program is to make sure that children affected by HIV are resilient and thriving. By working closely with government health facilities, we have been able to identify and enroll 17,860 children since the project began. We’re currently working with 5,262 children, including 787 who are HIV-positive themselves.

Each child has a case plan that was developed in collaboration with their parents or caregivers to identify the needs of the household. Depending on the situation, we may provide children and families with food, health insurance, transportation to treatment centers, feminine hygiene products, funds for school fees and uniforms, or support to start their own business or farming activity. We also promote HIV testing, treatment, and care services for everyone in the program.

Q: Can you tell us more about how you’re helping families economically?

We have different interventions for economic strengthening. One is to connect parents with the capital, equipment, and the training they need to start a small business. We have people doing hairdressing, selling groceries, making clothes, selling fast food, and tailoring clothes. We also identified farming activities that women could do—such as beekeeping and chicken farming—that is compatible with the changing climate.

We also train families to use a voluntary savings model. This allows communities to loan startup capital amongst themselves, while keeping a fund on the side for emergencies. We also invite government officials and bank employees to conduct trainings on a variety of topics, such as financial literacy, budgeting, bookkeeping, marketing, advertising, and developing a business plan.

Lastly, we have been able to enroll many of the participants in a government-run cash transfer program designed to support the most vulnerable OVC households.

Q: What sort of viral suppression levels are you seeing for children living with HIV?

The progress has been tremendous. It is very encouraging. We track the numbers every month, and we typically find that the newly enrolled children have the highest viral loads, while the ones who have been in our program are moving towards viral suppression. We have over 100 volunteers who regularly visit the households to assess each child’s wellbeing; that helps us to understand what may be contributing to a high viral load, so we can make plans to address it. The project has achieved a viral suppression rate of 84% among children living with HIV, which is higher than the general viral suppression rate of 73% in both counties, as reported by the County AIDS and STI Control Office. By the time the project ends in 2022, our goal is to attain 95% viral suppression for all of the children we work with.

Learn more about the project in the case study it produced for ViiV Healthcare and the Coalition.